Lecture 10 - Pharmacogenomics Flashcards

1
Q

what is an adverse drug reaction?

A

a negative/undesirable effect of drug treatment, they can influence different systems and are severely debilitating and potentially fatal

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2
Q

the 4th leading cause of death for people who are taking drugs to handle their illnesses

A

adverse drug reactions

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3
Q

what percent of hospital admissions in the UK have been attributed to adverse drug reactions

A

6.5%

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4
Q

what are demographic factors that impact response to drugs?

A
  • age
  • weight
  • sex
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5
Q

8/10 withdrawn drugs affect more ______ than ______

A

women, men

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6
Q

why do adverse drug reactions occur more in women than men?

A

women are hugely underrepresented in the research pipeline; pregnancy causes a person to undergo major physiological changes, impacting drug response

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7
Q

drug metabolism and elimination is less efficient in:

A

newborns and the elderly

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8
Q

how can genetic variation in a gene cause altered enzyme variation?

A
  • regulatory variation
  • coding variation
  • splice-site variation
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9
Q

regulatory variation influences:

A

gene expression (increases or decreases)

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10
Q

what are some examples of coding variation?

A
  • missense
  • start/stop lost
  • inframe insertion/deletion
  • stop gained
  • frameshift
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11
Q

what are some examples of splice-site variations?

A
  • create/abolish acceptor site
  • create/abolish donor site
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12
Q

examines the association between genetic variants and gene expression levels:

A

expression quantitative trait loci (eQTL)

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13
Q

what is cis eQTL?

A

genetic variants which impact the gene immediately downstream to it

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14
Q

what is trans eQTL?

A

genetic variants which impact the gene non-immediately downstream to it

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15
Q

what is the central dogma?

A

DNA –> RNA –> protein

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16
Q

genetic variations in the coding regions (SNPs, insertions, deletions) can lead to:

A

changes in protein function

17
Q

the part of a gene that carries relevent coding information

18
Q

the part of the gene that does not carry coding information (often regulatory)

19
Q

in gene splicing defects, parts of the _____ are often retained in the coding sequence

20
Q

what is pharmacogenomics?

A

how genetic factors influence drug response

21
Q

how does the genotype effect drug metabolism?

A

slow drug metabolism can increase drug toxicity, rapid drug metabolism can lead to a lack of drug efficacy

22
Q

precision health takes both _____ and _____ factors into account

A

genetic, non-genetic

23
Q

often framed as the right treatment, for the right patient, at the right time

A

precision health

24
Q

a key pharmacogene which acts as a drug metabolizing enzyme

25
CYP2D6 has many genetic variants, including:
single nucleotides variants, duplications, and deletions
26
codeine is converted to _____ by CYP2D6
morphine
27
why is it that ultra-rapid drug metabolizers should NOT be prescribed codeine?
they make way more morphine than expected for the given dose
28
what percent of people carry at least one clinically relevant pharmacogenomic variants
97%
29
facilitates genotype guided therapy
clinical practice guidelines (ex: Clinical Pharmacogenetics Implementation Consortium (CPIC))
30
an international consortium which provides systematic grading of evidence and clinical recommendations which aid in genotype guided therapy
Clinical Pharmacogenetics Implementation Consortium (CPIC)
31
what is myelosupression?
a chemotherapy related adverse reaction characterized by hematological toxicity
32
how does mercaptopurine work?
mercaptopurine (6-MP) is a purine antagonist and inhibits DNA synthesis/replication, which is cytotoxic (makes it a good cancer drug)
33
how does thiopurine methyltransferase (TPMT) work?
TPMT catabolizes (breaks down) thiopurines (including 6-MP)
34
allele frequency differences are linked to:
toxicity
35
how can drug toxicity be avoided in patients with allele-linked variants?
dose-reductions
36
TPMT is inactive in some patients, which leads to:
high drug toxicity (unable to breakdown 6-MP)